Decreased clot debris size and increased efficiency of acoustic vortex assisted high intensity focused ultrasound thrombolysis

High intensity focused ultrasound (HIFU) thrombolysis is a non-pharmacological, non-invasive treatment option for the restoration of blood flow through occluded vessels. This study demonstrated that the combination of an acoustic vortex with HIFU thrombolysis can decrease the size of clot debris, while simultaneously increasing the thrombolysis efficiency. The detected stable and inertial cavitation doses were lower in acoustic vortex assisted HIFU thrombolysis than in HIFU thrombolysis alone or in HIFU thrombolysis combined with regular focused ultrasound. Additionally, optical images indicated that these positive effects can be attributed to the aggregation of the generated clot debris and cavitation microbubbles in the focal region. This effectively enhances the interaction between the microbubbles and the clot, as well as its debris. Furthermore, the proposed method was effective under a flow velocity of up to 6 cm/s. This study demonstrated that the combination of an acoustic vortex and HIFU may provide a safer and more efficient thrombolysis approach by decreasing the debris size and by increasing the efficiency.